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Financial Assistance Process Policy

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Financial Assistance Process Policy UPMC POLICY AND PROCEDURE MANUAL POLICY: HS-RE0722 * INDEX TITLE: Revenue SUBJECT: Financial Assistance Process DATE: June 12, 2020 (effective July 1, 2020) I. POLICY UPMC is committed to providing financial assistance to people who have health care needs and are uninsured, underinsured, ineligible for a government program, do not qualify for governmental assistance (for example Medicare or Medicaid), or who are approved for Medicaid but the specific medically necessary service is considered non-covered by Medical Assistance, or otherwise unable to pay for medically necessary care. UPMC strives to ensure that the financial capacity of people who need health care services does not prevent them from seeking or receiving care. In order for UPMC to responsibly manage its resources and provide the appropriate level of assistance to the greatest number of persons in need, patients are expected to contribute to their cost of care based on their individual ability to pay. Patients applying for financial assistance are also expected to cooperate with UPMC’s procedures for obtaining financial assistance or other forms of payment, those with the financial capacity to © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 2 purchase health insurance will be encouraged to do so. In accordance with Federal Emergency Medical Treatment and Labor Act (EMTALA) regulations, no patients shall be screened for financial assistance or payment information prior to the rendering of a medical screening examination and to the extent necessary, services needed to treat the patient or stabilize them for transfer as applicable. The granting of financial assistance will not take into account age, gender, race, social or immigration status, sexual orientation, gender identity or religious affiliation. Links to policies referenced within this policy can be found in Section XIV. II. PURPOSE This policy addresses the various types and levels of financial assistance eligibility requirements, services that are included and excluded, and the process for securing financial assistance. III. SCOPE This policy applies to all fully integrated United States based UPMC hospitals and physician providers. (See attachments - Facility & Provider Listings). [Check all that apply] ☐ UPMC Children’s Hospital of Pittsburgh ☒ UPMC Pinnacle Hospitals © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 3 ☒ UPMC Magee-Women’s Hospital ☐ UPMC Carlisle ☒ UPMC Altoona ☐ UPMC Memorial ☒ UPMC Bedford ☐ UPMC Lititz ☒ UPMC Chautauqua ☐ UPMC Hanover ☒ UPMC East ☒ UPMC Muncy ☒ UPMC Hamot ☒ UPMC Wellsboro ☒ UPMC Horizon ☒ UPMC Williamsport ☒ UPMC Jameson ☒ Divine Providence Campus ☒ UPMC Kane ☒ UPMC Lock Haven ☒ UPMC McKeesport ☐ UPMC Cole ☒ UPMC Mercy ☒ UPMC Somerset ☒ UPMC Northwest ☐ UPMC Western Maryland ☒ UPMC Passavant ☒ UPMC Presbyterian Shadyside ☒ Presbyterian Campus ☒ Shadyside Campus ☒ UPMC Western Psychiatric Hospital ☒ UPMC St. Margaret © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 4 IV. DEFINITIONS For the purpose of this policy, the terms below are defined as follows: Emergency Care or Emergency Treatment: The care or treatment for emergency medical conditions as defined by EMTALA (Emergency Medical Treatment and Active Labor Act.) Financial Assistance: Financial assistance is the provision of healthcare services free of charge or at a discount to individuals who meet the established criteria. Family: As defined by the U.S. Census Bureau, a group of two or more people who reside together and who are related by birth, adoption, marriage, same- sex marriage, unmarried or domestic partners. Uninsured: The patient has no level of insurance (either private or governmental) or other potential assistance options, such as Victims of Violent Crimes, Auto Insurance, 3rd Party Liability, etc. to assist with meeting his/her payment obligations for health care services received from UPMC. Underinsured: The patient has some level of insurance (either private or governmental) or other potential assistance options, such as Victims of Violent Crimes, Auto Insurance, 3rd Party Liability, etc. but still has out-of-pocket expenses that exceed his/her financial ability to pay for health care services at UPMC. © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 5 Income/Family Income: Income/Family Income is determined by calculating the following sources of income for all qualifying household members. Wages, salaries, tips Business income Social Security income Pension or Retirements Income Dividends and Interest Rent and Royalties Unemployment compensation Workers’ compensation income Alimony and child support Legal Judgments Cash, bank accounts and money market accounts Matured certificates of deposit, mutual funds, bonds or other easily convertible investments that can be cashed without penalty Support Letters Other Income, such as income from trust funds, charitable foundations, etc. Items that are not considered in determining income include: Primary Residence Retirement Funds Primary Vehicle Indigence: Income falls below 250% of the Federal Poverty Guidelines. © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 6 Discounted Care: Uninsured (for UPMC Chautauqua WCA patients only, this includes those patients with insurance benefits that have become exhausted) and income falls between 251% and 400% of the Federal Poverty Guidelines. Financial or Medical Hardship: Financial assistance that is provided as a discount to eligible patients with annualized family income in excess of 250% of the Federal Poverty Guidelines and the out of pocket expense or patient liability resulting from medical services provided by UPMC exceeds 15% of family income. Federal Poverty Guidelines: Federal Poverty Guidelines are updated annually in the Federal Register by the United States Department of Health and Human Services under authority of subsection (2) of Section 9902 of Title 42 of the United States Code. Current Federal Poverty Guidelines can be referenced at http://aspe.hhs.gov/poverty-guidelines. Presumptive Charity Care: The use of external publicly available data sources that provide information on a patient’s ability to pay. V. ELIGIBILITY A. Services Eligible under this Policy. Financial assistance is available for eligible individuals who seek or obtain emergency and other medically necessary care from UPMC Providers. This Financial Assistance Policy (FAP) covers medically necessary care as defined by the Commonwealth of Pennsylvania. The Commonwealth of © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 7 Pennsylvania 55 Pa Code § 1101.21a defines medical necessity as: A service, item, procedure or level of care that is necessary for the proper treatment or management of an illness, injury or disability is one that: (1) Will, or is reasonably expected to, prevent the onset of an illness, condition, injury or disability; or (2) Will, or is reasonably expected to, reduce or ameliorate the physical, mental or developmental effects of an illness, condition, injury or disability; or (3) Will assist the recipient to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the recipient and those functional capacities that are appropriate of recipients of the same age. B. Services not eligible for financial assistance under this Policy regardless of whether they constitute medically necessary care include: a. Cosmetic surgery not considered medically necessary b. All transplant and related services c. Bariatrics and all related services d. Reproduction-related procedures (such as in- vitro fertilization, vasectomies, etc.) © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 8 e. Acupuncture f. Online virtual health care visits and related telemedicine services, including virtual specialty care and second opinion services g. Services performed at any UPMC Urgent Care location h. Package Pricing - services included in a package price are bundled and subject to an inclusive rate which is not subjected to any other forms of discounting. i. Private duty nursing j. Services provided and billed by a non UPMC entity which may include lab or diagnostic testing, dental, vision and speech, occupational or physical therapies k. Patient accounts or services received by a patient who is involved in pending litigation that relates to or may result in a generation of recovery based on charges for services performed at UPMC l. Other non-covered services such as laser eye surgery, hearing aids, etc. VI. ELIGIBILITY AND ASSISTANCE CRITERIA A. Financial assistance will be provided in accordance with UPMC’s mission and values. Financial assistance eligibility will be considered for uninsured and underinsured patients, and those for whom it would be a financial hardship to pay in full the expected out of pocket expenses for services provided by UPMC. Financial assistance will be provided in accordance with federal, state and local laws. Applicants for financial assistance are required to © 2020 UPMC All Rights Reserved POLICY HS-RE0722 PAGE 9 apply to public programs for available coverage, if eligible, as well as for pursuing public or private health insurance payment options for care provided by UPMC. Patients who do not cooperate in applying for programs that may pay for their healthcare services may be denied financial assistance. UPMC shall make affirmative efforts to help patients apply for public and private programs. Typically, financial assistance is not available for patient balances consisting only of co-pays
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